ArticleBMC public health2006
Validating the Johns Hopkins ACG Case-Mix System of the elderly in Swedish primary health care.
Article in BMC public health, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Population risk stratification tools and interventions for chronic disease management in primary care: a systematic literature review.BMC health services research · 2025Pooled it
- Population segmentation based on healthcare needs: a systematic review.Systematic reviews · 2019Pooled it
- Social Determinants of Health and 30-Day Mortality After Inpatient Elective Surgery.JAMA network open · 2026Article
- Risk Adjustment in Capitation Payments to Primary Care Providers: Does It Matter How We Account for Patients' Socioeconomic Status?Medical care · 2025Article
- The Impact of Frailty on Patients With AF and HFrEF Undergoing Catheter Ablation: A Nationwide Population Study.JACC. Advances · 2024Article
- Validity of the Johns Hopkins Adjusted Clinical Groups system on the utilisation of healthcare services in Norway: a retrospective cross-sectional study.BMC health services research · 2024Article
- Public funding for private for-profit centres and access to cataract surgery by patient socioeconomic status: an Ontario population-based study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
- Using the Johns Hopkins ACG Case-Mix System for population segmentation in a hospital-based adult patient population in Singapore.BMJ open · 2023Article
- Survival and health care costs after inpatient elective surgery: comparison of patients with and without chronic obstructive pulmonary disease.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Article
- A bias evaluation checklist for predictive models and its pilot application for 30-day hospital readmission models.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- Congestive heart failure and comorbidity as determinants of colorectal cancer perioperative outcomes.Updates in surgery · 2022Article
- Do healthcare needs-based population segments predict outcomes among the elderly? Findings from a prospective cohort study in an urbanized low-income community.BMC geriatrics · 2020Article
- Multimorbidity as a predictor of health service utilization in primary care: a registry-based study of the Catalan population.BMC family practice · 2020Article
- Article
- [Validity of adjusted morbidity groups with respect to clinical risk groups in the field of primary care].Atencion primaria · 2019Observational
- Capturing complexity in clinician case-mix: classification system development using GP and physician associate data.BJGP open · 2018Article
- Association between age, gender and multimorbidity level and receiving home health care: a population-based Swedish study.BMC research notes · 2015Article
- Variability in the initial costs of care and one-year outcomes of observation services.The western journal of emergency medicine · 2015Article
- Incentive-Based Primary Care: Cost and Utilization Analysis.The Permanente journal · 2015Article
- One-year outcomes associated with using observation services in triaging patients with nonspecific chest pain.Clinical cardiology · 2014Article
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3 authors.
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Abstract
backgroundIndividualbased measures for comorbidity are of increasing importance for planning and funding health care services. No measurement for individualbased healthcare costs exist in Sweden. The aim of this study was to validate the Johns Hopkins ACG Case-Mix System's predictive value of polypharmacy (regular use of 4 or more prescription medicines) used as a proxy for health care costs in an elderly population and to study if the prediction could be improved by adding variables from a population based study i.e. level of education, functional status indicators and health perception.
methodsThe Johns Hopkins ACG Case-Mix System was applied to primary health care diagnoses of 1402 participants (60-96 years) in a cross-sectional community based study in Karlskrona, Sweden (the Swedish National study on Ageing and Care) during a period of two years before they took part in the study. The predictive value of the Johns Hopkins ACG Case-Mix System was modeled against the regular use of 4 or more prescription medicines, also using age, sex, level of education, instrumental activity of daily living- and measures of health perception as covariates.
resultsIn an exploratory biplot analysis the Johns Hopkins ACG Case-Mix System, was shown to explain a large part of the variance for regular use of 4 or more prescription medicines. The sensitivity of the prediction was 31.9%, whereas the specificity was 88.5%, when the Johns Hopkins ACG Case-Mix System was adjusted for age. By adding covariates to the model the sensitivity was increased to 46.3%, with a specificity of 90.1%. This increased the number of correctly classified by 5.6% and the area under the curve by 11.1%.
conclusionThe Johns Hopkins ACG Case-Mix System is an important factor in measuring comorbidity, however it does not reflect an individual's capability to function despite a disease burden, which has importance for prediction of comorbidity. In this study we have shown that information on such factors, which can be obtained from short questionnaires increases the probability to correctly predict an individual's use of resources, such as medications.
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